Treatment of Patients with Cancer of an Unknown Primary Site

Few diagnoses in medicine engender as much pessimism as the diagnosis of metastatic cancer of an unknown primary site. Patients with this syndrome often have widespread metastatic disease, with involvement of multiple visceral sites such as the liver, lungs, and bones, and are often debilitated at the time of diagnosis. Early reports of chemotherapy in these patients documented low rates of response and no effect on the dismal median survival of three to four months, thereby strengthening arguments for a nihilistic approach14.Recently, however, the treatment of some patients with cancer of an unknown primary site has improved . . .